Reevaluation Of Blood And Ascites Fluid Endotoxin Levels In Patients With Chronic Liver Diseases(CLD)

Objective:To reevaluate the blood endotoxin concentration in patients with chronic liver diseases by means of dynamic turbidimetric analysis.Methods:Part One:We enroll 30 healthy voluteers,45 patients with chronic hepatitis B(CHB),66 patients with cirrhosis and 42 patients with hepatocellular carcinoma(HCC),and determine the peripheral blood endotoxin level by means of dynamic turbidimetric analysis.At the same time,we record the patients' serum biochemical index(such as total bilibubin,albumin,prothrombin time and aminotransferase),complication(such as upper gastrointestinal bleeding,hepatic encephalopathy and hepatic renal syndrome) as well as cause(hepatitis B or non-hepatitis-B) and Child-Pugh stage of cirrhosis.Part Two:We enroll 11 patients with cirrhosis and 5 patients with HCC.Each of them has ascitis and its endotoxin level is determined by means of dynamic turbidimetric analysis.At the same time,we record the patients' ascitis biochemical index(such as albumin,glucose or lactate dehydrogenase).Results:Part One:Peripheral blood endotoxin level in healthy volunteers, patients with CHB,cirrhosis and HCC is separately 0.018EU/ml,0.0928EU/ml, 0.2132EU/ml and 0.0792EU/ml.Setting up 0.1EU/ml as a limit,the positive rate is separately 48.9%,62.1%and 47.6%.The difference between the control group and CLD groups is significant(P＜0.001).Endotoxin levels between CLD subgroups have no significant difference.Neither do the level between complication subgroups, aetiological subgroups and Child-Pugh stage subgroups.Peripheral blood endotoxin level doesn't correlate with serum total bilirubin,albumin,prothrombin time or aminotransferase.Part Two:Ascitis endotoxin level in patients with cirrhosis and HCC is separately 0.0104EU/ml and 0.0208EU/ml.Setting up 0.1EU/ml as a limit, the positive rate is separately 9.1%and 0.The difference between cirrhosis group and HCC group is not significant.Ascitic endotoxin level doesn't correlate with ascitic albumin,glucose or lactate dehydrogenase. Conclusion:Normal people have few endotoxin in their peripheral blood while patients with CLD have different degrees of endotoxemia.It remains a problem to study further that if peripheral blood endotoxin level is corelated to the severity of liver injury.Patients with CLD have few endotoxin in their ascitis.